Almost 50% of Global Deaths Now Have A Recorded Cause

Introduction

Almost half of all deaths globally are now recorded with a cause, new data from WHO show, highlighting improvements countries have made on collecting vital statistics and monitoring progress towards the Sustainable Development Goals (SDGs).

Main Item

Of the estimated 56 million deaths globally in 2015, 27 million were registered with a cause of death, according to WHO's annual World Health Statistics. In 2005, only about a third of deaths had a recorded cause. Several countries have made significant strides towards strengthening the data they collect, including China, Turkey and the Islamic Republic of Iran, where 90% of deaths are now recorded with detailed cause-of-death information, compared with 5% in 1999.

Incomplete or incorrect information on those deaths that are registered also reduce the usefulness of those data for tracking public health trends, planning measures to improve health, and evaluating whether policies are working.

"If countries don't know what makes people get sick and die, it's a lot harder to know what to do about it," said Dr Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation. "WHO is working with countries to strengthen health information systems and to enable them to better track progress towards the Sustainable Development Goals."

The World Health Statistics, one of WHO's annual flagship publications, compiles data from the organization's 194 Member States on 21 health-related SDG targets, providing a snapshot of both gains and threats to the health of the world's people. While the quality of health data has improved significantly in recent years, many countries still do not routinely collect high-quality data to monitor health-related SDG indicators.

The report includes new data on progress towards universal health coverage.

Those data show that globally, ten measures of essential health service coverage have improved since 2000. Coverage of treatment for HIV and bed nets to prevent malaria have increased the most, from very low levels in 2000. Steady increases have also been seen in access to antenatal care and improved sanitation, while gains in routine child immunization coverage from 2000 to 2010 slowed somewhat between 2010 and 2015.

Access to services is just one dimension of universal health coverage; how much people pay out of their own pockets for those services is the other. The most recent data from 117 countries show that an average of 9.3% of people in each country spend more than 10% of their household budget on health care, a level of spending that is likely to expose a household to financial hardship.

A selection of data on progress towards the health-related SDG targets is presented below.

SDG 3: Ensure Healthy Lives and Promote Well-Being for All at All Ages

Target 3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births

• About 830 women died every day due to complications of pregnancy or childbirth in 2015. Reducing the maternal mortality ratio from 216 per 100 000 live births in 2015 to less than 70 per 100 000 by 2030 will require more than tripling the average annual rate of decline between 1990 and 2015.

Target 3.2: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality to at least as low as 12 per 1000 live births and under-5 mortality to at least as low as 25 per 1000 live births

• In 2015, the global neonatal mortality rate was 19 per 1000 live births and the under-five mortality rate in 2015 was 43 per 1000 live births, representing declines of 37% and 44% respectively from 2000.

Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases

• An estimated 2.1 million people were newly infected with HIV in 2015, 35% lower than the number newly infected in 2000 (about 3.2 million).
• There were an estimated 212 million malaria cases globally in 2015. About 60% of the population at risk had access to an insecticide-treated net 2015, compared to 34% in 2010.

Target 3.4: By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being.

• The probability of dying from diabetes, cancer, cardiovascular disease and chronic lung disease between ages 30 and 70 is 19%, a 17% decline from 2000. Still, the total number of deaths from noncommunicable diseases is increasing due to population growth and ageing.
• Almost 800 000 deaths by suicide occurred in 2015, with the highest rate in the WHO European Region (14.1 per 100 000 population) and the lowest rate in the WHO Eastern Mediterranean Region (3.8 per 100 000).

Target 3.5: Strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

• The global level of alcohol consumption in 2016 was 6.4 litres of pure alcohol per person aged 15 years or older. In 2015, more than 1.1 billion people smoked tobacco.

Target 3.6: By 2020, halve the number of global deaths and injuries from road traffic accidents

• About 1.25 million people died from road traffic injuries in 2013, a 13% increase from 2000. Road traffic injuries are the main cause of death for people aged 15-29 years.

Target 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.

• In 2016, 76.7% of women of reproductive age who were married or in-union had their family planning need met with a modern contraceptive method. This fell to 50% in the WHO African Region.
• The adolescent birth rate in 2015 was 44.1 per 1000 girls aged 15-19 years.

Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.

• Ten measures of essential health service coverage have improved since 2000. For example, 49% of people with TB are now detected and treated, compared with 23% in 2000, and 86% of children receive three doses of diphtheria-tetanus-pertussis vaccine, up from 72% in 2000.
• Recent data from 117 countries show that an average of 9.3% of people in each country spend more than 10% of their household budget on health care.

Target 3.9: By 2030, substantially reduce the number of deaths and illnesses from hazardous chemicals and air, water and soil pollution and contamination

• In 2012, indoor and outdoor air pollution caused an estimated 6.5 million deaths globally, or 11.6% of all deaths. The Western Pacific region bore the largest burden of these deaths.
• Unsafe water, sanitation and lack of hygiene were responsible for an estimated 871 000 deaths in 2012. Most of these deaths were in the African region and the South-East Asia region.

Selected Health-Related Targets Outside Goal 3

Target 1.2: By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions

• In 2014, average government health expenditure as a proportion of the total government expenditure was 11.7%, ranging from 8.8% in the Eastern Mediterranean region to 13.6% in the region of the Americas.

Target 2.2: By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating women and older persons

• 22.9% of children under 5 stunted (too short for their age), ranging from 6.1% in the European region to 33.8% in the Southeast Asian region.
• 6.0% of children under 5 were overweight, ranging from 4.1% in the African region to 12.8% in the European region.

Target 7.1: By 2030, ensure universal access to affordable, reliable and modern energy services

• In 2014, 57% of the world's population were reliant primarily on clean fuels, ranging from 16% in the African Region to more than 95% in the European Region

Target 16.1: Significantly reduce all forms of violence and related death rates everywhere

• In 2015 there were an estimated 468,000 murders, ranging from 1.7 per 100 000 in the Western Pacific region to 18.6 per 100 000 in the Region of the Americas.

Target 17.19: By 2030, build on existing initiatives to develop measurements of progress on sustainable development that complement gross domestic product, and support statistical capacity-building in developing countries

• In 2015 48% of deaths were registered with a cause of death, ranging from 5% of deaths in the African region to 95% in the European region.
• Only half of WHO Member States register at least 80% of deaths with information on the cause of death.